血清H-FABP、ApoAⅠ、VE-Cad水平与急性心肌梗死患者冠状动脉病变支数及预后的关系  

Correlation of Serum H-FABP,ApoAⅠ,VE-Cad Levels with the Number of Coronary Artery Lesions and Prognosis in Patients with Acute Myocardial Infarction

作　　者：朱彩虹[1] 李晨晨 ZHU Caihong;LI Chenchen(Department of Cardiology,Zhengzhou Seventh People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院心内科,河南郑州450000

出　　处：《河南医学研究》2025年第5期853-856,共4页Henan Medical Research

摘　　要：目的探讨血清心型脂肪酸结合蛋白(H-FABP)、血浆载脂蛋白AⅠ(ApoAⅠ)、血管内皮细胞钙黏着蛋白(VE-Cad)水平与急性心肌梗死(AMI)患者冠状动脉病变支数及预后的关系。方法将2022年6月至2024年1月在郑州市第七人民医院就诊的96例AMI患者纳入研究(观察组),根据患者病变支数将其分为单支组(32例)、双支组(40例)和多支组(24例),另取50例健康中老年人为对照组。比较对照组与观察组血清H-FABP、ApoAⅠ、VE-Cad水平差异;比较单支组、双支组、多支组血清H-FABP、ApoAⅠ、VE-Cad水平差异;使用Spearman秩相关分析法分析血清H-FABP、ApoAⅠ、VE-Cad水平与冠状动脉病变支数的相关性;比较不同预后AMI患者血清H-FABP、ApoAⅠ、VE-Cad水平差异;使用受试者工作特征(ROC)曲线分析血清H-FABP、ApoAⅠ、VE-Cad水平预测AMI患者不良预后的临床价值。结果与对照组比较,观察组血清H-FABP水平较高,而ApoAⅠ、VE-Cad水平较低(P<0.05);3组血清H-FABP、ApoAⅠ、VE-Cad水平差异有统计学意义(P<0.05);Spearman秩相关分析结果显示,血清H-FABP水平与冠状动脉病变支数呈正相关(P<0.05),血清ApoAⅠ、VE-Cad水平与冠状动脉病变支数呈负相关(P<0.05);与预后良好组比较,预后不良组血清H-FABP水平较高,而ApoAⅠ、VE-Cad水平较低(P<0.05);ROC曲线分析结果显示血清H-FABP、ApoAⅠ、VE-Cad水平预测AMI患者不良预后的最佳临界值分别为34.90μg·L^(-1)、0.95 g·L^(-1)、3.92 ng·L^(-1);此时曲线下面积分别为0.974、0.968、0.964(P<0.05);敏感度分别为100.00%、92.59%、100.00%;特异度分别为82.61%、86.96%、81.16%。结论AMI患者H-FABP水平较高,而ApoAⅠ、VE-Cad水平较低,且随着病变支数增加,AMI患者H-FABP水平会进一步增高,而ApoAⅠ、VE-Cad水平会进一步下降,且H-FABP、ApoAⅠ、VE-Cad水平在预测AMI患者不良预后中具有一定价值。Objective To investigate the correlation of serum heart-type fatty acid binding protein(H-FABP),apolipoprotein AⅠ(ApoAⅠ)and vascular endothelial cell cadherin(VE-Cad)with the number of coronary artery lesions and prognosis in patients with acute myocardial infarction(AMI).Methods A total of 96 patients with AMI treated in Zhengzhou Seventh People’s Hospital from June 2022 to January 2024 were included in the study(observation group),and they were divided into single-vessel group(32 cases),double-vessel group(40 cases)and multi-vessel group(24 cases)according to the number of diseased vessels.Another 50 healthy middle-aged and elderly people were selected as the control group.The differences of serum H-FABP,ApoAⅠand VE-Cad levels between the control group and the observation group were compared.The serum levels of H-FABP,ApoAⅠand VE-Cad were compared among the single-vessel group,double-vessel group and multi-vessel group.Spearman rank correlation analysis was used to analyze the correlation between serum H-FABP,ApoAⅠ,VE-Cad levels and the number of coronary artery lesions.The levels of serum H-FABP,ApoAⅠand VE-Cad in AMI patients with different prognosis were compared.Receiver operating characteristic(ROC)curve was used to analyze the clinical value of serum H-FABP,ApoAⅠand VE-Cad levels in predicting the poor prognosis of AMI patients.Results Compared with the control group,the observation group had a higher serum level of H-FABP and lower levels of ApoAⅠand VE-Cad(P<0.05).There were significant differences in serum H-FABP,ApoAⅠand VE-Cad levels among the three groups(P<0.05).Spearman rank correlation analysis showed that serum H-FABP level was positively correlated with the number of coronary artery lesions(P<0.05),and serum ApoAⅠand VE-Cad levels were negatively correlated with the number of coronary artery lesions(P<0.05).Compared with the good prognosis group,the poor prognosis group had a higher level of serum H-FABP and significantly lower levels of ApoAⅠand VE-Cad(P<0.05).ROC curve

关 键 词：急性心肌梗死 心型脂肪酸结合蛋白 血浆载脂蛋白AⅠ 血管内皮细胞钙黏着蛋白 病变支数 预后 

分 类 号：R543.31[医药卫生—心血管疾病]